World Neurosurg
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Spinal cord injuries (SCIs) are difficult to treat. The first animal SCI model (featuring the dropping of a weight) was established by Allen in 1911, and other animal models have been developed since then. ⋯ No consensus on an optimal animal model for cerebral research has emerged. We discuss the appropriate SCI models for studying secondary brain changes.
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Meningiomas are mostly benign intradural tumors. Concerning the spine, some of them can extend outside the canal or even develop extradurally but their primary attach is often located in the vertebral canal. Here we present the case of an exceptional purely intraforaminal meningioma mimicking a neurogenic tumor, involving the vertebral artery and presenting with cervicobrachial neuralgia and slight motor deficit.
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As previous studies reported, the balloon guide catheter is useful for identifying the fistula point during diagnosis of direct carotid-cavernous sinus fistula (d-CCF). We demonstrate an additional advantage of the balloon guide catheter during intraarterial endovascular treatment of d-CCF. ⋯ Using a balloon guiding catheter can reduce internal carotid artery flow near the fistula point at the cavernous segment of the internal carotid artery. As a result, better identification of the fistula point can be made, which allows easier placement of the microcatheter into the fistula point and more stable coil deployment.
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Pharmacogenomics may help personalize medicine and improve therapeutic selection. This is the first study investigating how pharmacogenomic testing may inform analgesic selection in patients with spine disease. We profile pharmacogenetic differences in pain medication-metabolizing enzymes across patients presenting at an outpatient spine clinic and provide preliminary evidence that genetic polymorphisms may help explain interpatient differences in preoperative pain refractory to conservative management. ⋯ This pilot study shows that a large proportion of the spine outpatient population may use pain medications for which they are suboptimal metabolizers. Further studies should assess whether these pharmacogenomic differences indicate differences in odds of receiving therapeutic benefit from surgery or if they can be used to generate more effective postoperative analgesic regimens.
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Central nervous system involvement is commonly seen in patients with human immunodeficiency virus (HIV) infection, with up to 2%-10% of patients presenting with intracranial mass lesions. The management of these lesions depends largely on their etiology and their relative frequency in the local population. ⋯ The prevalence of intracranial mass lesions in Filipino patients with HIV is 2.2%. The most common etiology was toxoplasmic encephalitis followed by tuberculosis. These findings are substantially different from other findings reported in the literature and should be considered in formulating guidelines for the Filipino population.